Intestinal obstruction associated with middle aortic syndrome: A case report

Area of Science:

• Cardiology
• Vascular Surgery
• Gastroenterology

Background:

• Middle Aortic Syndrome (MAS) is a rare condition characterized by stenosis of the aortic segment.
• MAS is often associated with other vascular abnormalities and can lead to serious complications.
• Takayasu's arteritis is a known cause of MAS, particularly in younger individuals.

Purpose of the Study:

• To report a unique case of middle aortic syndrome (MAS) in an elderly male patient.
• To illustrate the diagnostic challenges and management strategies for MAS presenting as intestinal obstruction.
• To emphasize the importance of considering MAS in the differential diagnosis of unexplained abdominal symptoms in older adults.

Main Methods:

• Case report of a male patient in his 70s presenting with symptoms of intestinal obstruction.
• Diagnostic workup included enhanced computed tomography (CT) and vascular reconstruction.
• Treatment involved initial nasointestinal catheterization followed by definitive vascular reconstruction.

Main Results:

• The patient was diagnosed with middle aortic syndrome (MAS) secondary to Takayasu's arteritis, leading to distal abdominal aorta occlusion.
• Intestinal obstruction was a secondary manifestation of MAS, initially relieved by catheterization but recurring.
• Vascular reconstruction successfully resolved the obstruction, with only a single recurrence due to dietary indiscretion post-operatively.

Conclusions:

• Middle aortic syndrome (MAS) is a rare but critical diagnosis, even in elderly patients.
• Prompt recognition and appropriate vascular intervention are crucial for managing MAS-induced intestinal obstruction.
• This case underscores the need for increased awareness and knowledge exchange regarding MAS for improved clinical outcomes.